title: Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events--European Registry in Atrial Fibrillation (PREFER in AF).
abstract: OBJECTIVE
  We sought to describe the management of patients with atrial fibrillation (AF) in Europe after the release of the 2010 AF Guidelines of the European Society of Cardiology.
  
  
  RESULTS
  The PREFER in AF registry enrolled consecutive patients with AF from January 2012 to January 2013 in 461 centres in seven European countries. Seven thousand two hundred and forty-three evaluable patients were enrolled, aged 71.5 ± 11 years, 60.1% male, CHA2DS2VASc score 3.4 ± 1.8 (mean ± standard deviation). Thirty per cent patients had paroxysmal, 24.0% had persistent, 7.2% had long-standing persistent, and 38.8% had permanent AF. Oral anticoagulation was used in the majority of patients: 4799 patients (66.3%) received a vitamin K antagonist (VKA) as mono-therapy, 720 patients a combination of VKA and antiplatelet agents (9.9%), 442 patients (6.1%) a new oral anticoagulant drugs (NOAC). Antiplatelet agents alone were given to 808 patients (11.2%), no antithrombotic therapy to 474 patients (6.5%). Of 7034 evaluable patients, 5530 (78.6%) patients were adequately rate controlled (mean heart rate 60-100 bpm). Half of the patients (50.7%) received rhythm control therapy by electrical cardioversion (18.1%), pharmacological cardioversion (19.5%), antiarrhythmic drugs (amiodarone 24.1%, flecainide or propafenone 13.5%, sotalol 5.5%, dronedarone 4.0%), and catheter ablation (5.0%).
  
  
  CONCLUSIONS
  The management of AF patients in 2012 has adapted to recent evidence and guideline recommendations. Oral anticoagulant therapy with VKA (majority) or NOACs is given to over 80% of eligible patients, including those at risk for bleeding. Rate is often adequately controlled, and rhythm control therapy is widely used.
authors.affiliation: University of Birmingham Centre for Cardiovascular Sciences and SWBH NHS Trust, City Hospital, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, Institute of Biomedical Research IBR 136, Birmingham B15 2TT, UK.
authors.forename: Paulus
authors.initials: P
authors.lastname: Kirchhof
authors.forename: Bettina
authors.initials: B
authors.lastname: Ammentorp
authors.forename: Harald
authors.initials: H
authors.lastname: Darius
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Caterina
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Le Heuzey
authors.forename: Richard John
authors.initials: RJ
authors.lastname: Schilling
authors.forename: Josef
authors.initials: J
authors.lastname: Schmitt
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Zamorano
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000453:epidemiology; D002309:Cardiology / Q000592:standards*; D015984:Causality; D015897:Comorbidity; D005060:Europe / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data*; D013923:Thromboembolism / Q000453:epidemiology / Q000517:prevention & control*; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K
keywords: Adherence to guidelines; Antiarrhythmic drugs; Anticoagulation; Atrial fibrillation; Catheter ablation; Guidelines; Management; Rate control; Registry; Rhythm control; Stroke